Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program.

TLDR

The Minnesota Heart Health Program is a 13‑year research and demonstration project aimed at reducing coronary heart disease morbidity and mortality in entire communities. The study aimed to evaluate the impact of this community‑wide program on cardiovascular risk factors. Matched community pairs received a 5‑ to 6‑year intervention of mass media, community organization, and direct education, while comparison sites continued baseline and follow‑up surveys. Although several components were effective in targeted groups, overall program effects were modest and largely within chance, suggesting that even an intensive intervention may not substantially accelerate the already favorable secular trends in health promotion and coronary heart disease risk factors.

Abstract

OBJECTIVES. The Minnesota Heart Health Program is a 13-year research and demonstration project to reduce morbidity and mortality from coronary heart disease in whole communities. METHODS. Three pairs of communities were matched on size and type; each pair had one education site and one comparison site. After baseline surveys, a 5- to 6-year program of mass media, community organization, and direct education for risk reduction was begun in the education communities, whereas surveys continued in all sites. RESULTS. Many intervention components proved effective in targeted groups. However, against a background of strong secular trends of increasing health promotion and declining risk factors, the overall program effects were modest in size and duration and generally within chance levels. CONCLUSIONS. These findings suggest that even such an intense program may not be able to generate enough additional exposure to risk reduction messages and activities in a large enough fraction of the population to accelerate the remarkably favorable secular trends in health promotion activities and in most coronary heart disease risk factors present in the study communities.